Kinesiology THURSDAY – Back Pain and the Golf Swing

It has been reported that approximately 35% of amateur golfers will experience sports-related back pain with that number rising to 55% in the pros. The golf swing is one of the most difficult movement patterns to master, requiring an intricate wind-up of the body in the transverse plane. Let’s take a quick look at what is required to swing without back pain.

The Backswing

Golf backswing

The backswing starting from the ground up requires a shift to the dominant leg (right leg for the right-handed golfer) and the following:

Subtalar joint eversion – ball of the big toe on the ground.
Knee flexion – knee positioned slightly bent and in line with the second toe
Hip flexion and internal rotation – a crease must be formed in the groin
Thoracic ipsilateral rotation and contralateral side bending – for the right handed golfer, this means right rotation and left side bending

This phase of the golf swing is designed to powerfully load the biggest muscle of the body, the gluteus maximus in preparation of delivering up to 4000 lbs. of force to the ball.

The follow-through

Golf swing follow through

The follow–through starting from the ground up requires a shift to the non-dominant leg (in a right-handed golfer, this is the left leg) and the following:

Subtalar joint eversion – big toe on the ground
Tibial internal rotation – creating a relative toe-in posture
Knee extension – straight but not locked
Hip extension, adduction and internal rotation – this loads the gluteus medius and psoas major
Thoracic ipsilateral rotation and contralateral side bending – for the right-handed golfer, this means left rotation and right side bending

This phase of the golf swing is designed to slow down the powerful swing.

So what does this mean for the low back? As the ground reaction forces travel from the foot up to the club head, the force needs to be dissipated below and above the lumbar spine to offer protection from injury. There is one key question to ask to begin to determine the cause of low back pain with the golf swing. When does the pain occur, during the backswing or follow-through?

If pain is during the backswing, the ability to load the dominant gluteus maximusneeds to be assessed. Do they feel their butt load at the top of the backswing?
If pain is during the follow-through, the ability to load the non-dominant gluteus medius and psoas major needs to be assessed. Do they have the flexibility to adduct and extend the hip at the end of the follow-through?

Can your golfer achieve the joint positions listed for each phase of the golf swing? The solution to low back pain and the golfer lies in your ability to assess the key motions required for each phase and restore what is missing. Fix what you find. There should be no back pain or tension felt at the end of either phase.

Conventional thinking says: Golfers get back pain because of a weak core or poor swing mechanics. Stretch and strengthen.

Real World Thinking says: The beginning and end of the golf swing require an intricate coordination of joint movements from the ground up. A lack of any of the motions will fail to load the appropriate hip muscles in each phase, placing the lumbar spine at risk.

Do your golfer’s a favor and check things out from the ground up. Here’s a link to our Golfer’s Daily Dozen for some exercise ideas.

Because nobody has time to be in pain.

Until next time…